ID DOSAGE REGIMENS & MONITORING FAAAAAAK Flashcards
Mild - Mod C. Difficile infection: Provide all of the possible regimens.
1st Line:
Vanco 125mg QID x 10-14d
2nd Line:
Fidaxomicin 200mg BID x 10d
OR
Metro 500mg TID x 10-14d
Severe, Uncomplicated C. Difficile infection: Provide all of the possible regimens.
1st Line:
Vanco 125mg QID x 10-14d
2nd Line:
Fidaxomicin 200mg BID x 10d
Severe, Complicated C. Difficile infection: Provide all of the possible regimens.
1st Line:
Vanco 125 - 500mg QID x 10-14d
+
Metro 500mg IV q8h
1st Recurrence of C. Difficile: What are the possible regimens?
Exact same options as Mild - Moderate (repeat courses of therapy).
2nd Recurrence of C. Difficile: What are the possible regimens?
Implement Pulsatile Vanco…
125mg QID x 2wks,
125mg TID x 1wk
125mg BID x 1wk
125mg OD x 1wk
125mg EOD x 2-8wks
What do we monitor for in C. difficile infection?
-Diarrhea / Fever / Abdom Pain / Sx Resolution
-XXX to Anti-Motility Agents
-WBC / Electrolytes
-Therapy Adherence
-Drug Side Effects
Latent Tuberculosis regimens: What are they?
Rifampin OD x 4mths
INH + Rifapentine OW x 3mths
INH OD x 9mths
Active Tuberculosis regimens: What are they?
Quad (RIPE) x 2mths THEN
INH + Rifampin x 4mths (6 total)
INH + Rifampin x 9mths (if Pyrazinamide isn’t present in regimen)
Initial / Baseline TB Monitoring Parameters…
-Weight / Physical Exam
-Vision Acuity
-CXR
-LFTs / CBCs / SCr
TB Efficacy Monitoring Parameters…
-Sputum q1-2wks (until 2 consecutive negatives)
-Wt / Vision / LFTs / CBCs / SCr (monthly for therapy duration)
-Drug Specific Interactions & Side Effects
< 1mth, Empiric Meningitis treatment: Go..
Ampicillin + AMG
OR
Ampicillin + Cefotaxime
1mth - 50yrs, Empiric Meningitis treatment: Go…
Vancomycin + 3rd Gen CS
> 50yrs, Empiric Meningitis treatment: Go…
Vancomycin + 3rd Gen CS + Ampicillin
Meningitis targeted treatment against S. pneumoniae.
Vanco + 3rd Gen CS (10-14d)
Meningitis targeted treatment against N. meningitidis.
One of the following:
3rd Gen CS
Ampicillin
Pen G
Meningitis targeted treatment against L. monocytogenes.
Ampicillin
OR
Pen G (+/-) AMG
Meningitis targeted treatment against S. agalactiae.
Ampicillin
OR
Pen G
Meningitis targeted treatment against H. influenzae.
3rd Gen CS
Meningitis targeted treatment against E. coli.
3rd Gen CS
Monitoring parameters for Meningitis patients…
-C & S
-CBCs
-Lumbar Puncture 2d after 1st (if conducted)
-Sx q4h
-DDIs / Side Effects
Empirical Endocarditis treatment if bacterial source is unknown & S. aureus NOT suspected…
Pen G
OR
Ampicillin + AMG
Empirical Endocarditis treatment if bacterial source is unknown & S. aureus IS suspected…
Pen G + Cloxacillin
OR
Ampicillin + Cloxacillin + AMG
OR
Vancomycin + AMG
Endocarditis with confirmed S. pneumoniae culture (& patient has Native Valves)…
Pen G x 4wks
OR
Ceftriaxone x 4wks
Endocarditis with confirmed S. pneumoniae culture (& patient has Prosthetic Valves)…
Pen G x 6wks
OR
Ceftriaxone x 6wks
(Both +/- AMG for first two weeks)
Endocarditis with MSSA (& patient has Native Valves)…
Beta Lactam (ie. Oxacillin / Nafcillin) x 6wks
OR
Cefazolin x 6wks (if Pen Allergy)
Endocarditis with MSSA (& patient has Prosthetic Valves)…
Beta Lactam (ie. Oxacillin / Nafcillin) + AMG + Rifampin x 6wks
OR
Cefazolin + AMG + Rifampin x 6wks
Endocarditis with MRSA (& patient has Native Valves)…
Vancomycin x 6wks
Endocarditis with MRSA (& patient has Prosthetic Valves)…
Vancomycin + AMG + Rifampin x 6wks
Endocarditis with confirmed Enterococci (either Native Valve or Prosthetic Valve)…
Ampicillin + AMG x 4-6wks
OR
Pen G + AMG x 4-6wks
Monitoring parameters for Endocarditis patients…
-C & S (q24h til negative)
-DDIs / Side Effects
-Signs & Sx Resolved
-HF Exacerbations Resolved (ie. SOB / Edema / Sudden Wt Gain)
-Improvement of Heart Murmur (but will not go away entirely)
